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{ <br /> Historical Pipeline <br /> 1 ` Poftlid Analysis RequestlChath, 1 Custody <br /> +L&Xaster Umtoele 1 2 3 J !! For Lancaster Laboratories use only <br /> I�Ciat fy$B i Ce• Acct.#: Ijq l 3 Group# 1 DB_96`10 Sample#: 531 S 7(06 77y <br /> Please print Analyses Requested SCR#: <br /> SWGlobal ID N117tlr16,l;t/L t0 Preservation Codes Preservative Codes <br /> rrI I I H=HCl T=Thiosulfate <br /> Site Address: I+�t7�.ti4 r to t� Rin. l 10141 CLN=HNO3 B=NaOH <br /> ChevronTexaoo Plot:M.Scott Mansholt Lead Consultant:SAIC m 5=H2SO4 O=Other <br /> 12 U <br /> Cons ultantlOffice: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 c� ❑J value reporting needed <br /> K3800 Watt Avenue,Suite 210,Sacramento,CA 95821 c ❑ co z HPP Risk Assessment Detection <br /> , t Limits <br /> Consultant Prj.Mgr.: v r, • �t V ❑ ❑ ❑ Q v <br /> Consultant Phone# 7 [ Fax#: TA p f � o o ❑Chromatograms <br /> op C3 p U <br /> ig ❑ [n D D <br /> Sampler: o o a <br /> 0 <br /> Z � r- ,� 0 <br /> CL co CO co co <br /> Field Repeat Top Time New o o w LU m x = = = <br /> LLI <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Ptym 0 U H m a F_ F <br /> 0 Comments!Remarks <br /> Ito 60 ?( <br /> V.5' 6P io I Z& Vzo x I K <br /> —101 5 _ sd 03 �6 y5 1 <br /> S — 101 S — 0" 6 iq qD I Yx x X <br /> s — aa' b? 03 163d IXj x <br /> S 19 5 — z7,s a 26 tap 1 X1 I <br /> Turnaround Time Requested(TAT)(check box) Relinquished by: �Dte <br /> t Time Received by: Date Time <br /> STD.TAT ❑24 hour ❑ 48 hour � 7d(} <br /> ❑ 5 day ❑ 72 hour ❑4 day Relinquished by: Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Receiver]by: Date Time <br /> S Soil T Duplicate sample Relinquished by Commercial Carrier: Reeeiv Date Time <br /> W Surface Water or Groundwater T Triplicate Sample 3 <br /> T Trip Blank-QA Sample N Pre-Purge Sample LIPS ed x Other dV <br /> 0 �^ <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g..product sample) Temperature/pH Upon Receiptg-77-17C° pH Custo y Seals Intact? eS No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.01 Rev. 1/14/05 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />